DR. MIMI QUYEN THAI THUC LE (MD) – Cardiovascular Disease Physician, NPI 1124070420

DR. MIMI QUYEN THAI THUC LE (MD) is a healthcare provider. based in Riverside, California. specializing in CARDIOVASCULAR DISEASE (CARDIOLOGY), INTERVENTIONAL RADIOLOGY, PERIPHERAL VASCULAR DISEASE, INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. A88869 (CA). The NPI Number for DR. MIMI QUYEN THAI THUC LE (MD) is 1124070420

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. MIMI QUYEN THAI THUC LE (MD)
NPI
1124070420
Phone
(866) 984-7483
Address
10800 MAGNOLIA AVE
Enumeration Date
16 May 2006
Last Update Date
13 December 2021

Doctor Profile

Medical School Name
PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
8669847483
Graduation Year
1999 (27 years ago)
PAC ID
1456380385
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20060803000316
Address ID
CA925554802MO27350AVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

3,010 CARDIOVASCULAR DISEASE (CARDIOLOGY) in CA

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Provider Addresses for DR. MIMI QUYEN THAI THUC LE (MD)

  • Kaiser Permanente Riverside Medical Center, 10800, Magnolia Avenue, Riverside, Riverside County, California, 92505, United States

    RIVERSIDE, CA 925053043

    Phone: (866) 984-7483

    Fax: (951) 353-5073

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-08-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060803000316IInternal MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only1514$0
View full utilization report →

Insurance plans in this area (ZIP 92505)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

How is DR. MIMI QUYEN THAI THUC LE (MD) identified in CMS data?
CMS-hosted NPPES data lists DR. MIMI QUYEN THAI THUC LE (MD) with NPI 1124070420.
Can I rely on DR. MIMI QUYEN THAI THUC LE (MD) being an active provider?
As of the registry snapshot, DR. MIMI QUYEN THAI THUC LE (MD) is marked active.
What taxonomy line describes DR. MIMI QUYEN THAI THUC LE (MD)?
For research purposes, treat DR. MIMI QUYEN THAI THUC LE (MD) as Cardiovascular Disease Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DR. MIMI QUYEN THAI THUC LE (MD)?
DR. MIMI QUYEN THAI THUC LE (MD)'s geographic hint is Riverside, California in our summary view.
Is the information about DR. MIMI QUYEN THAI THUC LE (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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